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Ingelheim, Germany, 11 December 2012 – Boehringer Ingelheim has taken the voluntary decision to discontinue treatment with the oral anticoagulant dabigatran etexilate in a phase II clinical trial in patients with artificial heart valves. The company based its decision on interim results from the phase II RE-ALIGNTM trial which suggested that the investigated dosing regimen did not achieve the desired results in this patient population.

"Despite the trial not having delivered the desired interim results, we believe that we have provided data to contribute to the better understanding of this particular patient group and indication. It also underlines the urgent need for new advancements in anticoagulation for patients with artificial heart valves." commented Professor Klaus Dugi, Corporate Senior Vice President Medicine Boehringer Ingelheim.
"Other studies with dabigatran etexilate are continuing and dabigatran remains one of the best investigated anticoagulants, having been studied in the RE-VOLUTION program with more than 40.000 patients involved."

The decision on the RE-ALIGN® clinical research project does not alter the positive benefit/risk profile of Pradaxa® in the already approved and established indications in preventing strokes and systemic embolism in patients with non-valvular atrial fibrillation as well as in preventing venous thromboembolism following elective knee- or hip-replacement-surgery.1

Dabigatran etexilate is not approved and not recommended for use in patients with prosthetic (artificial) heart valves. The presence of an artificial heart valve in patients is a clinical condition that is distinct from those for which dabigatran is an approved treatment. In view of the interim trial results, the company is currently in discussions with the relevant regulatory authorities to reinforce the product label text accordingly and to discuss appropriate communication to physicians and relevant health care providers.

The effectiveness and safety profile of dabigatran etexilate in its licensed indications is proven and well documented in an extensive clinical trial programme,1-6 which led to world-wide regulatory approvals in over 80 countries to date.7

The long term benefit of the treatment has just recently been demonstrated in a long-term clinical trial in the prevention of stroke and systemic embolism in patients with atrial fibrillations, providing data from over four years of clinical treatment.8 The positive benefit-risk-profile of dabigatran was also recently reconfirmed by the European Medicines Agency9 and the U.S. Food and Drug administration (FDA).10Clinical experience with dabigatran continues to grow and equates to over one million patient-years in all licensed indications11 and exceeding that of all other novel oral anticoagulants.12

Boehringer Ingelheim remains in continuous communication with all regulatory and clinical trial authorities to ensure patient safety, which is of the utmost importance to the company.

NOTES TO THE EDITORS

Stroke Prevention in Atrial Fibrillation
AF is the most common sustained heart rhythm condition, with one in four adults over the age of 40 developing the condition in their lifetime.13,14 People with AF are more likely to experience blood clots, which increases the risk of stroke by five-fold.15,16 Up to three million people worldwide suffer strokes related to AF each year.17,18 Strokes due to AF tend to be severe, with an increased likelihood of death (20%), and disability (60%).19

Ischaemic strokes are the most common type of AF-related stroke, accounting for 92% of strokes experienced by AF patients and frequently leading to severe debilitation.20 Appropriate anticoagulation therapy can help to prevent many types of AF-related strokes and improve overall patient outcomes.21

Worldwide, AF is an extremely costly public health problem, with treatment costs equating to $6.65 billion in the US and over €6.2 billion across Europe each year.22,23 Given AF-related strokes tend to be more severe, this results in higher direct medical patient costs annually.24 The total societal burden of AF reaches €13.5 billion per year in the European Union alone.13

About dabigatran etexilate
Dabigatran etexilate is at the forefront of a new generation of oral anticoagulants/direct thrombin inhibitors (DTIs)25 targeting a high unmet medical need in the prevention and treatment of acute and chronic thromboembolic diseases.

Potent antithrombotic effects are achieved with direct thrombin inhibitors by specifically blocking the activity of thrombin (both free and clot-bound), the central enzyme in the process responsible for clot (thrombus) formation. In contrast to vitamin-K antagonists, which variably act via different coagulation factors, dabigatran etexilate provides effective, predictable and consistent anticoagulation with a low potential for drug-drug interactions and no drug-food interactions, without the need for routine coagulation monitoring or dose adjustment.

Boehringer Ingelheim
The Boehringer Ingelheim group is one of the world’s 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates globally with 145 affiliates and more than 44,000 employees. Since it was founded in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel medications of high therapeutic value for human and veterinary medicine.

As a central element of its culture, Boehringer Ingelheim pledges to act socially responsible. Involvement in social projects, caring for employees and their families, and providing equal opportunities for all employees form the foundation of the global operations. Mutual cooperation and respect, as well as environmental protection and sustainability are intrinsic factors in all of Boehringer Ingelheim’s endeavors.

In 2011, Boehringer Ingelheim achieved net sales of about 13.2 billion euro. R&D expenditure in the business area Prescription Medicines corresponds to 23.5% of its net sales.

Footnotes

Please be advised

This release is from Boehringer Ingelheim Corporate Headquarters in Germany. Please be aware that there may be national differences between countries regarding specific medical information, including licensed uses. Please take account of this when referring to the information provided in this document. This press release is not intended for distribution within the USA, UK or Canada.

European Medicines Agency: Opinions on annual re-assessments, renewals of marketing authorisations and accelerated assessment procedures. Adopted at the CHMP meeting of 15-18 October 2012. Viewed October 2012 http://www.ema.europa.eu/docs/en_GB/document_library/Other/2012/10/WC500134406.pdf

Global Atlas on Cardiovascular Disease Prevention and Control, World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization 2011. Viewed May 2012 at http://www.world-heart-federation.org/fileadmin/user_upload/documents/Publications/Global_CVD_Atlas.pdf.

Atlas of Heart Disease and Stroke, World Health Organization, September 2004. Viewed Nov 2012 at http://www.who.int/cardiovascular_diseases/en/cvd_atlas_15_burden_stroke.pdf